Isolated Late Penile Metastasis of an Adenocarcinoma of the Rectum

A Case Report and Review of the Literature of Penile Metastasis From Rectal Cancer

Background

Metastatic involvement of the penis in cases of rectal cancer is exceptionally rare condition. Our clinical case report and review of the literature will contribute in complementing currently limited data on penile metastasis from rectal cancer.

Case report

We report a case of a 64-year-old male diagnosed with penile metastasis from rectal cancer. The patient was treated with neoadjuvant chemoradiotherapy followed by total mesorectal excision (TME). However, penile metastasis developed 3 years later, clinically presenting as penile pain and solid formations along the entire length of the penis with visible tumor in the head of the penis. The amputation of penis was performed, and adjuvant chemotherapy was prescribed. The patient survived only 6 months.

Conclusion

Penile metastasis from rectal cancer in most cases is a lethal pathology that indicates wide dissemination of oncological disease and has a very poor prognosis. Aggressive surgical treatment is doubtful in metastatic disease as this will negatively affect the quality of life.

Penile Metastasis from Rectal Carcinoma: Case Report and Review of the Literature

Background

Metastasis of rectal cancer to the penis is a very rare condition with less than 40 cases found in the literature.

Case Report

We here report a case of a 41-year-old man who was diagnosed with rectal cancer which later metastasized to the penis. The patient was treated with neoadjuvant radiotherapy, underwent rectal resection, had adjuvant chemotherapy, and, despite that, had penile metastasis 2 years later. Palliative penectomy as well as bilateral orchiectomy with suprapubic cystostomy were performed. The patient died 2 months after the diagnosis. All the previous cases mentioned in the literature are reviewed as well.

Conclusion

The prognosis of penile metastasis from rectal cancer is poor and life expectancy is short. The mechanism of rectal cancer metastasis spread to the penis is unknown. The most acceptable theory is retrograde venous spread. There are several treatment options; however, no single treatment option is associated with superior results.